Prevalence and treatment of central hypogonadism and hypoandrogenism in women with hypopituitarism

Olivius, Catharina; Landin‐Wilhelmsen, Kerstin; Olsson, Daniel S; Johannsson, Gudmundur; Tivesten, Åsa

doi:10.1007/s11102-018-0895-1

Cited by 17 publications

(7 citation statements)

References 35 publications

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“…Recently, it was documented in 184 consecutive women with GH replacement therapy that the oestrogen replacement treatment rate in women ≤ 52 years was lower compared to the replacement rates of the other pituitary hormone deficiencies (74% versus 100%); androgen replacement treatment was even lower in these women [71].…”

Section: Central Hypogonadism In Femalesmentioning

confidence: 99%

Management of Hypopituitarism

Alexandraki

Grossman

2019

JCM

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Hypopituitarism includes all clinical conditions that result in partial or complete failure of the anterior and posterior lobe of the pituitary gland’s ability to secrete hormones. The aim of management is usually to replace the target-hormone of hypothalamo-pituitary-endocrine gland axis with the exceptions of secondary hypogonadism when fertility is required, and growth hormone deficiency (GHD), and to safely minimise both symptoms and clinical signs. Adrenocorticotropic hormone deficiency replacement is best performed with the immediate-release oral glucocorticoid hydrocortisone (HC) in 2–3 divided doses. However, novel once-daily modified-release HC targets a more physiological exposure of glucocorticoids. GHD is treated currently with daily subcutaneous GH, but current research is focusing on the development of once-weekly administration of recombinant GH. Hypogonadism is targeted with testosterone replacement in men and on estrogen replacement therapy in women; when fertility is wanted, replacement targets secondary or tertiary levels of hormonal settings. Thyroid-stimulating hormone replacement therapy follows the rules of primary thyroid gland failure with L-thyroxine replacement. Central diabetes insipidus is nowadays replaced by desmopressin. Certain clinical scenarios may have to be promptly managed to avoid short-term or long-term sequelae such as pregnancy in patients with hypopituitarism, pituitary apoplexy, adrenal crisis, and pituitary metastases.

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Section: Central Hypogonadism In Femalesmentioning

confidence: 99%

Management of Hypopituitarism

Alexandraki

Grossman

2019

JCM

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“…Several studies have reported an increased risk of premature mortality in patients with hypopituitarism, and this risk is especially higher in women, mainly due to the higher risk of cardiovascular events (85,86). It has been suggested that the underdiagnosed and undertreated hormonal deficiencies could explain, at least in part, this increased mortality (87,88), and some studies have suggested that hypogonadism is a key factor behind this increased mortality in hypopituitary women (85,86).…”

Section: Functional Female Hypogonadismmentioning

confidence: 99%

ENDOCRINE OBESITY: Pituitary dysfunction in obesity

Ruiz¹,

Vázquez²,

Pellitero³

et al. 2022

European Journal of Endocrinology

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Obesity, the growing pandemic of the XXI century, is associated with multiple organ dysfunction, either by a direct increase in fatty organ content or by indirect modifications related to general metabolic changes driven by a specific increase in biologic products. The pituitary gland is not protected against such a situation. Different hypothalamic-pituitary axes experience functional modifications initially oriented to an adaptive situation that, with years of obesity, turn to maladaptive dynamics that contribute to perpetuating obesity and specific symptoms of their hormonal nature. This paper reviews the recent knowledge on obesity-related pituitary dysfunction and its pathogenic mechanisms and discusses potential therapeutic actions aimed at contributing to ameliorating the complex treatment of severe cases of obesity.

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“…Sex steroid replacement should be started in all women with HH who are at premenopausal age and be individualized for older women (30,68). Noteworthy, hypopituitarism removes the natural survival advantage that women have over men in terms of vascular complications; therefore, outcomes observed in natural menopause should not be extrapolated to women with frequently underdiagnosed and undertreated in women compared with men (77,78). While the goal of treatment of HH in older women is to control hot flushes, in young women, the goal is to prevent damage induced by estrogen deficiency.…”

Section: Sex Steroid Replacement Therapymentioning

confidence: 99%

Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism

Garmes

Boguszewski

Miranda

et al. 2021

Archives of Endocrinology and Metabolism

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Hypopituitarism is a disorder characterized by insufficient secretion of one or more pituitary hormones. New etiologies of hypopituitarism have been recently described, including head trauma, cerebral hemorrhage, and drug-induced hypophysitis. The investigation of patients with these new disorders, in addition to advances in diagnosis and treatment of hypopituitarism, has increased the prevalence of this condition. Pituitary hormone deficiencies can induce significant clinical changes with consequent increased morbidity and mortality rates, while hormone replacement based on current guidelines protects these patients. In this review, we will first discuss the different etiologies of hypopituitarism and then address one by one the clinical aspects, diagnostic evaluation, and therapeutic options for deficiencies of TSH, ACTH, gonadotropin, and GH. Finally, we will detail the hormonal interactions that occur during replacement of pituitary hormones.

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Prevalence and treatment of central hypogonadism and hypoandrogenism in women with hypopituitarism

Cited by 17 publications

References 35 publications

Management of Hypopituitarism

Management of Hypopituitarism

ENDOCRINE OBESITY: Pituitary dysfunction in obesity

Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism

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